Orlando Harmon
MIT Health offers a centralized source of comprehensive health insurance, care, and treatment at its medical centers, as well as a range of health and wellness promotion programs. MIT requires that all students have health insurance, and they are automatically enrolled in the MIT Student Health Insurance Plan (MIT SHIP). Students with MIT SHIP coverage can access all services at MIT Medical, but those with outside insurance may only be covered for certain services and may be billed for the rest. MIT's health insurance plans are designed to meet legal requirements, and they cover expenses for hospitalization, diagnostic tests, physical therapy, surgery, prescription medication, and obstetrical care.
| Characteristics | Values |
|---|---|
| MIT Health Insurance Coverage | MIT Health offers a single, centralized source of comprehensive health insurance, care, and treatment at their medical centers. |
| MIT Health Insurance Requirements | All students must have health insurance that meets the Massachusetts Student Health Insurance Plan (SHIP) requirements. Students with J-1 visas under MIT sponsorship must also meet US Department of State regulations. |
| Tuition Coverage | Tuition covers most services at MIT Health, including primary care, medical specialties, urgent care, mental health counseling, and other services. |
| Outside Insurance | Students with outside insurance can use it for services at MIT Medical, but they may be responsible for full charges if their insurance does not cover the services. |
| Copayments | Copayments, or "copays," are fixed amounts paid for specific healthcare services or prescriptions. Copay amounts vary depending on the service or medication type. |
| Coinsurance | Coinsurance is the percentage of the medical bill that the insured person must pay after reaching their deductible amount. |
| Deductible | A deductible is the total amount the insured person must pay for covered services before the insurance company pays for any expenses. |
| Outside Care | The MIT student and staff insurance plans offer significant coverage at outside clinics and hospitals. |
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What You'll Learn
MIT Health Insurance Requirements
MIT health insurance plans meet the legal requirements of the US government. If you have a J-1 visa, the US Department of State requires that you and your family members with J-2 visas have health insurance. MIT's High Deductible Health Plan for employees does not meet J-1 exchange visitor visa requirements.
MIT offers two health plan options. You are eligible for health plan coverage if you are paid by MIT, appointed to work at MIT for at least three months, and work at least 50% of the normal full-time work schedule. When selecting a health plan, you must choose who will be covered: you can choose between an individual plan, employee + spouse, employee + children, or a family plan.
If you are an MIT student, you can get care at MIT Health, even if you do not buy the MIT Student Health Plan (SHIP). All regular and special students registered with 27 or more units will be automatically enrolled in and billed for individual membership in the MIT Student Health Plan. Students with comparable health and hospital insurance may be able to waive the MIT insurance if the insurance meets two requirements:
- Coverage must meet the Massachusetts minimum standards
- The insurance must cover the student while they are in the US
If you want to waive the mandatory MIT insurance, you need to complete the Waiver Request Form and return it to the Student Insurance Office by August 1 for the Fall term and by January 2 for the Spring term.
MIT health insurance covers check-ups, mental health services, laboratory tests, prescription drugs, and visits to the doctor or emergency room. It also covers transportation and lodging expenses up to an annual benefit maximum of $5,000 for covered services. This coverage is provided when access to covered services is not available within 100 miles of the member's residence, and the member must travel to an in-network provider for the covered services.
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Out-of-Pocket Costs
Deductibles
A deductible is the total amount of money that an individual must pay out-of-pocket for certain covered services before their insurance company will start paying for any expenses. For example, if a plan has an annual deductible of $2,000, the individual must pay for all their medical expenses until they reach that amount. After that, the insurance company will pay some or all of the remaining costs.
Coinsurance
Even after reaching the deductible amount, individuals may still need to pay a portion of their medical expenses through coinsurance. This is usually a percentage of the total bill. For example, if an individual has a 20% coinsurance clause in their plan and receives a medical bill for $500 after meeting their deductible, they will have to pay $100 (20% of $500), while their insurance company pays the remaining $400.
Copayments
Copayments, or "copays," are fixed amounts that individuals pay for specific healthcare services or prescriptions. Copays vary depending on the type of service or medication. For instance, a doctor's appointment may have a lower copay than an emergency room visit, and generic medications typically have lower copays than brand-name drugs.
Annual Out-of-Pocket Limit
An annual out-of-pocket limit caps the total amount an individual has to pay for covered services in a year. Once this limit is reached, the insurance company will cover 100% of the cost of covered services for the rest of the year.
It is worth noting that MIT health plans cover a range of services, including mental health care. MIT provides MyLife Services, which offers up to four free and confidential counseling sessions with a licensed mental health professional. After these initial sessions, individuals may continue using their health insurance coverage, but copayments, coinsurance, or deductible charges may apply. Additionally, MIT health plans cover transportation and lodging expenses up to an annual maximum benefit of $5,000 for covered services that are not available within 100 miles of the member's residence.
While MIT health insurance can help mitigate out-of-pocket costs, some individuals have expressed concerns about the quality of care provided by MIT Medical, suggesting that those with significant long-term health conditions may want to consider seeking care elsewhere.
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Outside Insurance Coverage
MIT Health offers a single, centralized source of comprehensive health insurance, care, and treatment at its medical centers, as well as a broad range of health and wellness promotion programs. MIT requires that all incoming students submit a medical history and document immunity against certain infectious diseases. Students with MIT SHIP coverage should receive a Blue Cross Blue Shield of Massachusetts ID card, while students remaining on a parent's plan should carry an ID card for that plan. Students do not need to show an insurance card to receive care at MIT Medical, but they will need to provide insurance information if they need to receive care outside of MIT Medical.
Tuition covers most services provided at MIT Health, including primary care, many medical specialties, seven-day-a-week urgent care, mental health and counseling, and other services. MIT Health's Student Mental Health and Counseling Service offers assistance to students dealing with personal concerns, including anxiety, depression, relationship problems, and stress. These services are available free of charge to MIT students.
MIT also provides MyLife Services as an employee benefit for faculty, staff, postdoc associates and fellows, and household members. MyLife Services provides up to four free and confidential counseling sessions per person, per concern, with a licensed mental health professional. If you or your household member chooses to continue seeing a mental health professional for an ongoing concern after those four sessions, you may use your health insurance coverage; copayments, coinsurance, or deductible charges may be required.
MIT's health insurance plans meet the legal requirements for J-1 visas, and students with J-1 visas under MIT sponsorship are automatically enrolled in the MIT Student Health Insurance Plan. Students with J-1 visas must have insurance that meets US Department of State regulations for themselves and their spouses and children who accompany them.
If you want to buy an MIT-sponsored health plan, you must buy it within 30 days of your arrival, and you must continue making regular payments to keep your insurance coverage for as long as you stay. It is important to understand that health insurance does not pay for everything. When an insurance plan "covers" a particular healthcare service, it means that it will pay for at least part of the cost. Some healthcare services are "covered in full," meaning you will pay nothing extra for that service, but for other healthcare services, you will have to pay part of the cost. To buy and keep your health insurance, you will need to make regular payments, or "premiums," to a health insurance company. You might have to make a premium payment every month. As long as you remain eligible and keep paying your premiums, the health insurance company agrees to pay for part of your medical bills. However, you will also have to pay part of the cost when you get medical care, known as your "out-of-pocket cost."
Additionally, there is the concept of a "deductible." A deductible is the total amount of your own money that you must pay for certain covered services before the insurance company will pay for any of your medical expenses. For example, if your plan's annual deductible is $2,000, you must pay for all your medical expenses until you reach that amount. After that, the insurance company will pay some or all of the remaining cost. There is also "coinsurance," which is the percentage you must pay after reaching your deductible amount, with the insurance company paying the rest. For instance, if your insurance plan includes 20% coinsurance and you get a medical bill for $500 after reaching your annual deductible, you will pay $100, and your insurance company will pay $400.
Finally, there are "copayments," or "copays," which are fixed amounts you pay for specific healthcare services or prescriptions. You might have different copays for different medical services or types of prescriptions. For example, if you have an appointment at a doctor's office, your copay might be $25, but if you go to the emergency room, your copay could be $200. When you get a generic prescription medication, your copay might be $15, while a brand-name medication could have a $50 copay.
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Student Health Insurance Plan
MIT offers a range of health insurance plans for its students, staff, postdoc associates, postdoc fellows, and their household members. These plans are designed to help cover the cost of healthcare services, which can be very expensive in the United States.
The MIT health insurance plans can help pay for regular check-ups, laboratory tests, vaccines, and prescription medication. The plans also cover transportation and lodging expenses up to an annual benefit maximum of $5,000 for covered services. Additionally, MIT provides MyLife Services as an employee benefit, which offers up to four free and confidential counselling sessions with a licensed mental health professional.
For students, MIT offers a University-sponsored Student Health Insurance Plan, which is required for international students unless they are sponsored by an embassy. Domestic students with adequate coverage of their own can waive this plan. The annual premium for the University-sponsored plan is added to each student's fees.
It is important to note that health insurance does not cover all expenses. There may be premiums, deductibles, copayments, and coinsurance that the individual is responsible for paying. When selecting a health insurance plan, it is essential to carefully review the benefits and limitations to ensure that the policy meets your needs.
If you are considering enrolling in the MIT Student Health Insurance Plan, be sure to review the specific details of the plan, including coverage, costs, and any exclusions or limitations. Additionally, keep in mind that you may still have the option to seek healthcare services outside of MIT, depending on your insurance plan and provider network.
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MIT Health Services
To get the most out of MIT Health Services, students are encouraged to select a Primary Care Provider to coordinate their care needs. Students with MIT SHIP coverage should receive a Blue Cross Blue Shield of Massachusetts ID card and carry it with them at all times. While students do not need to show an insurance card to receive care at MIT Medical, they will need to provide insurance information if they need to receive care outside of MIT Medical. It is important for students to know what services are covered by their insurance plan, as some services at MIT Medical, such as contact lens fitting, are only covered for students with MIT SHIP coverage. If a student has waived MIT SHIP but chooses to receive these services on campus, they will be billed, and their outside insurance may or may not cover these services.
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Frequently asked questions
Yes, MIT Medical accepts outside insurance. Students with outside insurance will need to provide their insurance information if they need to receive care outside of MIT Medical.
MIT Health offers a centralized source of comprehensive health insurance, care, and treatment at their own medical centers, as well as a broad range of clinical services and medical and dental specialties. MIT Health also offers student mental health and counseling services.
Health insurance is mandatory under Massachusetts state law. All regular students and special students registered with at least 75% of the full-time academic requirement are automatically enrolled in the MIT Student Health Insurance Plan (SHIP).
Through their affiliations with Boston's leading hospitals, MIT clinicians can refer patients with more serious conditions to the most appropriate specialists.
